05D0860743 CLIA NUMBER - VISTA DEL MAR CHILD & FAMILY SERVICES

Laboratory Demographics

CLIA Number: 05D0860743

Facility Name: VISTA DEL MAR CHILD & FAMILY SERVICES

Facility Address:
3200 MOTOR AVENUE ATTN HEALTH CENTER
LOS ANGELES, CA
ZIP 90034
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Facility Phone Number: 310 836-1223

Facility Type: Other - CONGREGATE LIVING

Certificate Type: Waiver

NPI Number: 1174655708

Taxonomy: 251S00000X - Community/Behavioral Health
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

CLIA Record

Field Name	Field Value
CLIA Number	05D0860743
LAB Type	Other - CONGREGATE LIVING
Facility Name	VISTA DEL MAR CHILD & FAMILY SERVICES
Street	3200 MOTOR AVENUE ATTN HEALTH CENTER
City	LOS ANGELES
State	CA
ZIP	90034
Phone	310 836-1223
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024